Provider Demographics
NPI:1104979186
Name:ASPDEN, EMILY ANN (MPT)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:ASPDEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9520 STATELINE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-5411
Mailing Address - Country:US
Mailing Address - Phone:814-746-9548
Mailing Address - Fax:
Practice Address - Street 1:3939 W RIDGE RD
Practice Address - Street 2:SAFE HARBOR - EARLY INTERVENTION
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-1879
Practice Address - Country:US
Practice Address - Phone:814-746-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016850225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101602506Medicaid